Prostate cancer is a frightening condition for any man, and certainly one of the most dreaded diagnoses. The good news, however, is that prostate cancer is highly treatable and actually has extremely good survival rates – so long as it is caught early.
This is why getting a prostate cancer biopsy is such a wise move. As much as this might be uncomfortable and scary, if it leads to the condition being caught early, it could prevent a far more serious outcome and much more uncomfortable procedures.
But what should you expect from the procedure? How effective is it? And is it painful?
Using Biopsy to Detect Prostate Cancer
A prostate cancer biopsy is essentially a process in which a small amount of tissue is removed from a patient. This is done so that it can be examined more closely under a microscope, in order to make a more accurate diagnosis.
Cancer is caused by mutated cells, which in turn are often damaged by free radicals, radiation, and age. This can cause harm to the DNA, which prevents the cells from functioning properly. Because cells reproduce via mitosis – making a precise copy of the DNA in the process – these damaged cells can proliferate and grow until they eventually account for a substantial amount of tissue. This is what we refer to as a tumor.
During a biopsy of the prostate cancer, the doctors are looking for signs of such growth under a microscope, and will, therefore, be able to decide on the best course of action for your treatment (should it be needed).
The prostate is a walnut-sized gland that is located behind the genitals and is responsible for producing fluids that help create and support sperm. During prostate biopsies, needles will be used to collect tissue samples from this gland. The needle is useful because it allows the surgeon to reach deeply and extract tissue without needing to create an incision.
There are multiple types of prostate biopsy, defined by the entry point for the needle. The transrectal biopsy for example involves inserting the needle through the wall of the rectum. Conversely, the transperineal biopsy involves inserting the needle through the skin between the anus and the scrotum. This latter method is less common and does require a small incision to be made. Usually, an MRI or CT scanner will also be used to help cautiously guide the biopsy.
You will need to lie on your side with your knees pulled up to your chest during this process. The area surrounding the injection site will also be numbed using an injection. Ultrasound images will be taken if necessary.
Once inserted, the doctor or surgeon will use the syringe to extract a thin, cylindrical amount of tissue. This is uncomfortable in brief spurts as the needle draws each sample.
Recovery will usually take around 24-48 hours. During this time, most doctors recommend that patients avoid engaging in any vigorous activity which may cause discomfort and bleeding. You may notice that it feels sore, particularly when you are seated. You may also notice light bleeding even if you do refrain from engaging in lots of activities.
In some cases, you may also notice that your semen takes on a reddish color or has a rust-like tint. This is due to small amounts of blood in your semen. This may last for several weeks, so don’t be alarmed if this doesn’t disappear right away.
You will likely be asked to take antibiotics for a few days following the procedure. This is to prevent the onset of an infection. Infections occur when bacteria get into open wounds, which can in turn cause tissue damage.
You should make sure to inform your doctor if you notice any signs of infection. These include:
- Pain in the area that gets worse
You should also look out for difficulty urinating, or prolonged or heavy bleeding. Stay in touch with your doctor and they will talk you through any concerns you may have.
Getting Your Results
For many patients, the most stressful part of the biopsy is waiting to get the results. This is understandably an anxious time, but it’s important to remember once again that you are doing the best thing by getting these tests.
You may be wondering what the results might look like once you receive them!
After the biopsy, a pathologist – a doctor that specializes in this kind of work - will look at the sample to try to find tissue abnormalities. They will then provide a pathology report that will include information such as:
- A description of the biopsy sample that describes the color and consistency of the tissue, which may be relevant
- Description of the cells which explains how they appear under the microscope. Cancerous cells are called adenocarcinoma. Some cells may be abnormal but not cancerous. These are referred to as “prostatic intraepithelial neoplasia.”
- A cancer grading. This uses the Gleason scale to score cancer between 2-10. The higher the score, the more likely the cancerous tissue is to spread and grow.
- Finally, the diagnosis will include comments regarding whether further tests are needed and what the next step should be. Remember that a cancer diagnosis itself does not necessarily mean that you will require treatment. In many cases, this can result in a “wait and watch” recommendation. Speak with your physician, and try not to second guess the outcome.
While this is a stressful process, you are in the best hands and the prognosis is usually very good.
Adult Pediatric Urology & Urogynecology, PC | Urologists Omaha & Council Bluffs, IA
Adult Pediatric Urology, PC has 7 board-certified physicians and attentive, dedicated staff. We have served Nebraska and Iowa since 1982 with two locations in Omaha and Council Bluffs. Our Omaha location includes an accredited outpatient surgical center with state-of-the-art equipment and a comfortable waiting area just minutes from Interstate 680. Our physicians successfully perform hundreds of traditional and no-scalpel vasectomies every year.
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